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他汀类药物治疗对主动脉瘤患者动脉瘤大小、生长速率及基质金属蛋白酶-9水平的影响:一项系统评价与荟萃分析

The effects of statin therapy on aneurysm size, growth rate, and matrix metalloproteinases-9 levels in patients with aortic aneurysm: a systematic review and meta-analysis.

作者信息

Pramana Ketut Angga Aditya Putra, Pintaningrum Yusra, Rahmat Basuki

机构信息

General Practitioner of Mataram University, Mataram, Indonesia.

Interventional Cardiology Division, Cardiology and Vascular Department, Faculty of Medicine, Mataram University, Mataram, Indonesia.

出版信息

Egypt Heart J. 2023 Oct 13;75(1):88. doi: 10.1186/s43044-023-00407-9.

Abstract

BACKGROUND

Aortic aneurysm enlargement over time causes rupture, which frequently results in death. The family of proteases known as matrix metalloproteinases (MMP) is assumed to be proteolytic activity involved in the growth of aortic aneurysms. Statins are pleiotropic lipid-lowering medications with anti-inflammatory action. Statins can lower aneurysmal enlargement and MMP secretion, according to a number of studies, however the evidence is still up for debate. The purpose of this study is to assess how statins affect aortic aneurysm patient's aneurysm diameter size, growth rate, and MMP-9 levels.

METHODS

From January 2000 to December 2022, electronic journal searches in PubMed, ScienceDirect, and Cochrane were conducted to discover papers evaluating the effects of statin treatment in patients with aortic aneurysm. Aneurysm diameter size, growth rate, and MMP-9 levels were the outcomes we were looking for. Meta-analyses were run on the included studies, and mean differences (MD) and 95% CIs were calculated with Review Manager v5.4.

RESULTS

Our analysis includes a total of ten research. Statin medication substantially reduced aneurysm diameter size by 0.30 mm (P = 0.04; MD - 0.30; 95% CI - 0.58 to - 0.01) and growth rate by 0.34 mm/year (P < 0.00001; MD - 0.34; 95% CI - 0.40 to - 0.29) compared to placebo. There was no significant change in MMP-9 concentrations between individuals with aortic aneurysm who took a statin and those who did not.

CONCLUSION

Overall, this meta-analysis demonstrates that statin medication is considerably helpful in reducing aneurysm diameter size and aneurysmal growth rate in individuals with aortic aneurysm.

摘要

背景

随着时间的推移,主动脉瘤扩大可导致破裂,这常常导致死亡。被称为基质金属蛋白酶(MMP)的蛋白酶家族被认为是参与主动脉瘤生长的蛋白水解活性物质。他汀类药物是具有抗炎作用的多效性降脂药物。多项研究表明,他汀类药物可降低动脉瘤的扩大和MMP的分泌,然而证据仍存在争议。本研究的目的是评估他汀类药物如何影响主动脉瘤患者的动脉瘤直径大小、生长速率和MMP-9水平。

方法

从2000年1月至2022年12月,在PubMed、ScienceDirect和Cochrane上进行电子期刊检索,以发现评估他汀类药物治疗对主动脉瘤患者影响的论文。我们关注的结果是动脉瘤直径大小、生长速率和MMP-9水平。对纳入的研究进行荟萃分析,使用Review Manager v5.4计算平均差异(MD)和95%置信区间(CI)。

结果

我们的分析共纳入了10项研究。与安慰剂相比,他汀类药物治疗可使动脉瘤直径大小显著减小0.30mm(P = 0.04;MD -0.30;95%CI -0.58至-0.01),生长速率降低0.34mm/年(P < 0.00001;MD -0.34;95%CI -0.40至-0.29)。服用他汀类药物的主动脉瘤患者与未服用者之间的MMP-9浓度没有显著变化。

结论

总体而言,这项荟萃分析表明,他汀类药物治疗对减小主动脉瘤患者的动脉瘤直径大小和动脉瘤生长速率有显著帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cad/10575821/6a666ad747ab/43044_2023_407_Fig1_HTML.jpg

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